• 文献检索
  • 文档翻译
  • 深度研究
  • 学术资讯
  • Suppr Zotero 插件Zotero 插件
  • 邀请有礼
  • 套餐&价格
  • 历史记录
应用&插件
Suppr Zotero 插件Zotero 插件浏览器插件Mac 客户端Windows 客户端微信小程序
定价
高级版会员购买积分包购买API积分包
服务
文献检索文档翻译深度研究API 文档MCP 服务
关于我们
关于 Suppr公司介绍联系我们用户协议隐私条款
关注我们

Suppr 超能文献

核心技术专利：CN118964589B侵权必究
粤ICP备2023148730 号-1Suppr @ 2026

文献检索

告别复杂PubMed语法，用中文像聊天一样搜索，搜遍4000万医学文献。AI智能推荐，让科研检索更轻松。

立即免费搜索

文件翻译

保留排版，准确专业，支持PDF/Word/PPT等文件格式，支持 12+语言互译。

免费翻译文档

深度研究

AI帮你快速写综述，25分钟生成高质量综述，智能提取关键信息，辅助科研写作。

立即免费体验

肺切除术后持续气道正压通气（CPAP）：一项随机临床试验。

Continuous positive airway pressure (CPAP) after lung resection: a randomized clinical trial.

作者信息

Roceto Lígia dos Santos, Galhardo Fernanda Diório Masi, Saad Ivete Alonso Bredda, Toro Ivan Felizardo Contrera

机构信息

Clinical Hospital, School of Medical Sciences, Universidade Estadual de Campinas, CampinasSão Paulo, Brazil.

Clinical Hospital, School of Medical Sciences, Universidade Estadual de Campinas, CampinasSão Paulo, Brazil, BSc. Physiotherapist (PT), Intensive Care Unit of Clinical Hospital, School of Medical Sciences, Universidade Estadual de Campinas (Unicamp), Campinas, São Paulo, Brazil.

出版信息

Sao Paulo Med J. 2014;132(1):41-7. doi: 10.1590/1516-3180.2014.1321525.

DOI:10.1590/1516-3180.2014.1321525
PMID:24474079
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10889452/
Abstract

CONTEXT AND OBJECTIVE

Noninvasive mechanical ventilation during the postoperative period (PO) following lung resection can restore residual functional capacity, improve oxygenation and spare the inspiratory muscles. The objective of this study was to assess the efficacy of continuous positive airway pressure (CPAP) associated with physiotherapy, compared with physiotherapy alone after lung resection.

DESIGN AND SETTING

Open randomized clinical trial conducted in the clinical hospital of Universidade Estadual de Campinas.

METHOD

Sessions were held in the immediate postoperative period (POi) and on the first and second postoperative days (PO1 and PO2), and the patients were reassessed on the discharge day. CPAP was applied for two hours and the pressure adjustment was set between 7 and 8.5 cmH2O. The oxygenation index (OI), Borg scale, pain scale and presence of thoracic drains and air losses were evaluated.

RESULTS

There was a significant increase in the OI in the CPAP group in the POi compared to the Chest Physiotherapy (CP) group, P = 0.024. In the CP group the OI was significantly lower on PO1 (P = 0,042), than CPAP group. The air losses were significantly greater in the CPAP group in the POi and on PO1 (P = 0.001, P = 0.028), but there was no significant difference between the groups on PO2 and PO3. There was a statistically significant difference between the groups regarding the Borg scale in the POi (P < 0.001), but there were no statistically significant differences between the groups regarding the pain score.

CONCLUSION

CPAP after lung resection is safe and improves oxygenation, without increasing the air losses through the drains.

CLINICAL TRIAL REGISTRATION

NCT01285648.

摘要

背景与目的

肺切除术后的无创机械通气可恢复残余功能容量，改善氧合并减轻吸气肌负担。本研究的目的是评估持续气道正压通气（CPAP）联合物理治疗与单纯物理治疗相比，在肺切除术后的疗效。

设计与地点

在坎皮纳斯州立大学临床医院进行的开放随机临床试验。

方法

在术后即刻（POi）以及术后第1天和第2天（PO1和PO2）进行治疗，并在出院日对患者进行重新评估。应用CPAP两小时，压力调整范围为7至8.5 cmH₂O。评估氧合指数（OI）、博格量表、疼痛量表以及胸腔引流管情况和漏气情况。

结果

与胸部物理治疗（CP）组相比，CPAP组在POi时OI显著升高，P = 0.024。在CP组中，PO1时的OI显著低于CPAP组（P = 0.042）。CPAP组在POi和PO1时的漏气情况显著更严重（P = 0.001，P = 0.028），但在PO2和PO3时两组之间无显著差异。两组在POi时关于博格量表有统计学显著差异（P < 0.001），但在疼痛评分方面两组之间无统计学显著差异。

结论

肺切除术后使用CPAP是安全的，可改善氧合，且不会增加通过引流管的漏气情况。

临床试验注册号

NCT01285648。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46be/10889452/0f831ddaa37d/1516-3180-spmj-132-01-00041-gf6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46be/10889452/65d2e59eea9a/1516-3180-spmj-132-01-00041-gf1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46be/10889452/900cd4983e77/1516-3180-spmj-132-01-00041-gf5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46be/10889452/a99db4712ecd/1516-3180-spmj-132-01-00041-gf2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46be/10889452/9ee172929189/1516-3180-spmj-132-01-00041-gf3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46be/10889452/02dfd4305d4e/1516-3180-spmj-132-01-00041-gf4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46be/10889452/0f831ddaa37d/1516-3180-spmj-132-01-00041-gf6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46be/10889452/65d2e59eea9a/1516-3180-spmj-132-01-00041-gf1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46be/10889452/900cd4983e77/1516-3180-spmj-132-01-00041-gf5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46be/10889452/a99db4712ecd/1516-3180-spmj-132-01-00041-gf2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46be/10889452/9ee172929189/1516-3180-spmj-132-01-00041-gf3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46be/10889452/02dfd4305d4e/1516-3180-spmj-132-01-00041-gf4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46be/10889452/0f831ddaa37d/1516-3180-spmj-132-01-00041-gf6.jpg

相似文献

1
Continuous positive airway pressure (CPAP) after lung resection: a randomized clinical trial.肺切除术后持续气道正压通气（CPAP）：一项随机临床试验。
Sao Paulo Med J. 2014;132(1):41-7. doi: 10.1590/1516-3180.2014.1321525.
2
CPAP increases 6-minute walk distance after lung resection surgery.CPAP 可增加肺切除术后 6 分钟步行距离。
Respir Care. 2012 Mar;57(3):363-9. doi: 10.4187/respcare.01267. Epub 2011 Sep 26.
3
Comparison of gas exchange after lung resection with a Boussignac CPAP or Venturi mask.肺切除术后 Boussignac CPAP 或文丘里面罩通气时气体交换的比较。
Br J Anaesth. 2014 May;112(5):929-35. doi: 10.1093/bja/aet477. Epub 2014 Feb 3.
4
Effect of Boussignac continuous positive airway pressure ventilation on Pao2 and Pao2/Fio2 ratio immediately after extubation in morbidly obese patients undergoing bariatric surgery: a randomized controlled trial.肥胖症患者行减重手术后即刻拔管时，Boussignac 持续气道正压通气对 PaO2 和 PaO2/Fio2 比值的影响：一项随机对照试验。
J Clin Anesth. 2016 Nov;34:562-70. doi: 10.1016/j.jclinane.2016.06.024. Epub 2016 Jul 17.
5
Efficacy of continuous positive airway pressure and incentive spirometry on respiratory functions during the postoperative period following supratentorial craniotomy: A prospective randomized controlled study.经颅幕上手术后持续气道正压通气和激励式呼吸训练对呼吸功能的影响：一项前瞻性随机对照研究。
J Clin Anesth. 2017 Nov;42:31-35. doi: 10.1016/j.jclinane.2017.08.010. Epub 2017 Aug 7.
6
Randomized trial of bilevel versus continuous positive airway pressure for acute pulmonary edema.双水平气道正压通气与持续气道正压通气治疗急性肺水肿的随机试验
J Emerg Med. 2014 Jan;46(1):130-40. doi: 10.1016/j.jemermed.2013.08.015. Epub 2013 Sep 24.
7
A multicentre randomised controlled trial of the use of continuous positive airway pressure and non-invasive positive pressure ventilation in the early treatment of patients presenting to the emergency department with severe acute cardiogenic pulmonary oedema: the 3CPO trial.一项关于持续气道正压通气和无创正压通气在急诊科严重急性心源性肺水肿患者早期治疗中应用的多中心随机对照试验：3CPO试验。
Health Technol Assess. 2009 Jul;13(33):1-106. doi: 10.3310/hta13330.
8
Differential lung ventilation for increased oxygenation during one lung ventilation for video assisted lung surgery.在电视辅助肺手术的单肺通气期间，采用差异肺通气以增加氧合。
J Cardiothorac Surg. 2019 May 6;14(1):89. doi: 10.1186/s13019-019-0910-2.
9
Postoperative respiratory muscle training in addition to chest physiotherapy after pulmonary resection: A randomized controlled study.肺切除术后呼吸肌训练联合胸部物理治疗：一项随机对照研究。
Physiother Theory Pract. 2020 Mar;36(3):378-385. doi: 10.1080/09593985.2018.1488189. Epub 2018 Jul 6.
10
Mini-ventilation for improved oxygenation during lung resection surgery.在肺切除手术中采用小潮气量通气以改善氧合。
Anaesth Intensive Care. 2011 May;39(3):456-9. doi: 10.1177/0310057X1103900317.

引用本文的文献

1
Non-invasive positive pressure ventilation for prevention of complications after pulmonary resection in lung cancer patients.无创正压通气预防肺癌患者肺切除术后并发症
Cochrane Database Syst Rev. 2019 Mar 6;3(3):CD010355. doi: 10.1002/14651858.CD010355.pub3.
2
The effect of non-invasive positive airway pressure therapy following thoracic surgical procedures: protocol for a systematic review.胸外科手术后无创正压通气治疗的效果：一项系统评价方案
Syst Rev. 2015 Jun 12;4:83. doi: 10.1186/s13643-015-0073-8.

本文引用的文献

1
Risk factors for prolonged air leak after pulmonary resection.肺切除术后持续性漏气的危险因素。
Thorac Surg Clin. 2010 Aug;20(3):359-64. doi: 10.1016/j.thorsurg.2010.03.002.
2
Physiotherapy in the perioperative period.围手术期的物理疗法。
Best Pract Res Clin Anaesthesiol. 2010 Jun;24(2):283-9. doi: 10.1016/j.bpa.2010.02.003.
3
Role of non-invasive ventilation (NIV) in the perioperative period.无创通气（NIV）在围手术期的作用。
Best Pract Res Clin Anaesthesiol. 2010 Jun;24(2):253-65. doi: 10.1016/j.bpa.2010.02.007.
4
Incentive spirometry following thoracic surgery: what should we be doing?胸外科手术后的激励性肺量计法：我们应该怎么做？
Physiotherapy. 2009 Jun;95(2):76-82. doi: 10.1016/j.physio.2008.11.003. Epub 2009 Mar 3.
5
Influence of pleural drainage on postoperative pain, vital capacity and six-minute walk test after pulmonary resection.胸腔引流对肺切除术后疼痛、肺活量及6分钟步行试验的影响。
J Bras Pneumol. 2008 Dec;34(12):1003-7. doi: 10.1590/s1806-37132008001200004.
6
Novel uses of noninvasive ventilation.
Respir Care. 2009 Feb;54(2):212-19; discussion 219-22.
7
The physiologic effects of noninvasive ventilation.无创通气的生理效应。
Respir Care. 2009 Jan;54(1):102-15.
8
Noninvasive ventilation for acute respiratory failure after lung resection: an observational study.肺切除术后急性呼吸衰竭的无创通气：一项观察性研究。
Intensive Care Med. 2009 Apr;35(4):663-70. doi: 10.1007/s00134-008-1317-z. Epub 2008 Oct 14.
9
Respiratory muscle evaluation in elective thoracotomies and laparotomies of the upper abdomen.
J Bras Pneumol. 2006 Mar-Apr;32(2):99-105. doi: 10.1590/s1806-37132006000200004.
10
Prophylactic use of noninvasive ventilation in patients undergoing lung resectional surgery.肺切除手术患者无创通气的预防性应用。
Respir Med. 2007 Jul;101(7):1572-8. doi: 10.1016/j.rmed.2006.12.002. Epub 2007 Jan 25.